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ARCHIVED REPORTS XR0012689
Environmental Health - Public
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EHD Program Facility Records by Street Name
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E
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ELEVENTH
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515
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3500 - Local Oversight Program
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PR0544792
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ARCHIVED REPORTS XR0012689
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Entry Properties
Last modified
11/19/2024 10:19:09 AM
Creation date
9/3/2019 11:55:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012689
RECORD_ID
PR0544792
PE
3528
FACILITY_ID
FA0004849
FACILITY_NAME
BILLS BAIT & BEACON GAS
STREET_NUMBER
515
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
515 W ELEVENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\wng
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EHD - Public
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_ _ <br /> Ca <br /> IlTurnia Water Labs, Inc. .� <br /> P.0.BOX 4249, ( �� <br /> 1430 CARPENTERLANE-� ••ter•. ` //,, /f, <br /> MODESTO.CA 95352 J - <br /> II P}iONE(209)5274050 <br /> -7&9 <br /> - CHAIN OF CUSTODY RECORD <br /> r . <br /> Q� 04E c <br /> SAitAt �igtr' <br /> ) : n y p44 <br /> 111 Number <br /> Station of REp9ARK5 <br /> Number Date Time � � Con- <br /> tion <br /> on- � <br /> Station Location <br /> '- tainers <br /> C <br /> Re 1 b A to Y (signature]: R <br /> Time Received b ' <br /> t Relinquished 6y(signeture); Date / Time Receival by (signature): <br /> pf [ any or Agency: Company or Agency: <br /> V q d1; <br /> ILf teary`or Agency, <br /> Relinquished by(slgasture): Date / Tine Received by (signature): Y' <br /> Relinquished b . <br /> 4 Date / Tuns Respired by (signature): <br /> Compaq or Agency: Coapaey or Agency: Cur <br /> pany or Agency: Comparky or Agency:. <br /> Relinquished byl(s'.gnature): Date / Time Received for Laboratory by: bete / Time Remarks/Shipping Information <br /> Con�any or Agen''y: (signature f U ' <br /> : <br /> f , <br /> I <br />
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